Reingruber Alert: Medicare & COVID-19 Update

7/10/2020 - By Claudia Reingruber, CPA, CHC

More Medicare Cost Report Due Dates Extended

Period Ending     Originally Due    Extended Due Date      NEW Extended Due Date

12/31/2019        05/31/2020        07/31/2020               08/31/2020

01/31/2020        06/30/2020        08/31/2020               N/A

02/29/2020        07/31/2020        09/30/2020               N/A

  • Note: These are automatic extensions - no request needed.

Credit Balance Report (CMS-838) Due Date Extension

Quarter Ending    Originally Due    Extended Due Date

03/31/2020        04/30/2020         07/31/2020

  • The Credit Balance Reports for the quarters ended 03/31/2020 and 06/30/2020 will now have the same due date
  • Note: 100% suspension of Medicare payments will occur if your Credit Balance Report is filed late

Advance Beneficiary Notice (ABN-R-131)

  • ABN-R-131 has been reissued with a new expiration date of 06/23/2023
  • This new version will become mandatory on 08/31/2020
  • The updated form and instructions are available here

PEPPER - CMS has Directed that PEPPER Distribution Resume

  • SNF PEPPER for Q4FY19
    • Original release date was 04/06/2020 
    • New release date:  07/29/2020
    • Will include new Target Area for "3- to 5-day readmissions"
    • Added due to a "potential incentive" under PDPM to discharge and readmit a Part A patient in order to reset the variable per diem (VPD) rate 
    • PDPM includes an interrupted stay policy to combine episodes when separated by up to three days in order to continue the same VPD schedule
    • If a patient is discharged and readmitted after more than three consecutive days, then it is considered to be a "new stay" and the VPD resets
    • This target will provide data on discharges and readmissions for analysis 
    • Compliance Programs should be updated if an SNF is at or above the 80th percentile
    • A revised PEPPER User's Guide for SNFs for Q4FY19 is available here
  • HHA PEPPER for Q4FY19
    • Original release date was 07/08/2020
    • New release date: 08/12/2020
    • The PEPPER User's Guide for HHAs has not yet been updated for Q4FY19

The Healthcare Division at Saltmarsh can help you:

  • Assist with Credit Balance Reporting or related questions
  • Evaluate compliance with all notices of non-coverage
  • Ensure proper application of Section 1135 waivers
  • Update your SNF compliance program for PDPM risk areas

If you have questions about your particular circumstances, please contact our team or call (800) 477-7458.

Visit our COVID-19 RESOURCE HUB for ongoing updates and information. Due to the ever-changing nature of this event, you should always consult a professional.

Related Posts